This invention relates in general to medical devices particularly for drainage of a tracheal tube and to a new and useful suction adapter and medical draining set into a method of using the same.
In general, the patient under respiratory treatment is connected to a respirator through a suction adapter which is provided between the respirator line and an endotracheal tube and serves as a device for introducing the suction catheter.
As soon as, in order to introduce the suction catheter, the respiration is interrupted, there is a hazard, particularly under a respiration with a positive end expiratory pressure, that larger amounts of un-oxygenated blood will suddenly enter the arterial branch of the blood carrying system. A following acute volume load on the left heart portion and a supply with not oxygenated, venous blood frequently leads to a bradycardia, under adverse circumstances even to a stop of the heart. Consequently, what is required is a suction adapter which makes it possible to introduce the suction catheter without interrupting the respiration.
In German OS No. 23 08 400, an endotracheal respiratory tube is shown with an introduced catheter for continuous draining by suction. In an upper part of the device, an outer flap valve is provided for introducing the catheter, and two inner superjacent flap valves of rubber are mounted in a pipe connection.
The suction catheter advanced through the inlet opening thus penetrates an elastic outer seal and an inner seal and can be employed for continuously draining the bronchial secretion under simultaneous respiration.
Another suction adapter for endotracheal tubes for draining under continuous respiration is shown in the German periodical "Anaesthesist" 1981, pages 533-534 in an article by Ch. Spiss, W. Mauritz and P. Sporn. This suction adapter which is connectable to the respirator line and the tube is designed with a lateral, toothed slide for exposing an opening in the side wall, through which a suction catheter can be introduced.
The prior art suction adapters are effective in preventing the respirator line from being disconnected, and thus avoiding special hazards due to hemodynamics. With a positive end expiratory pressure respiration (PEEP), however, a substantial pressure drop during the draining operation cannot be prevented. In addition, they do not ensure sterile conditions with regard to the patient, sometimes not even with regard to the ambience.
The invention is directed to a development of an adapter of the above mentioned kind, permitting in a PEEP method to substantially maintain the pressure even during the suctorial draining operation, and ensuring a sterile manipulation. Further, under conditions of fouling, the adapter must be easy to clean, and it must be inexpensive in series manufacture.
In accordance with the invention there is provided a suction adapter for connecting a suction catheter to a tracheal tube which is also connected to a respirator and which comprises a hollow body or fitting which has a first opening with a tracheal tube receiving fitting. The hollow body also includes a second opening with a respirator line connector and a third opening which is advantageously aligned with the tracheal tube opening for introducing a suction catheter. The first or outer valve 10 closes the third opening and it includes a valve lid member which may be stopped in a completely closed or completely open position. The second or inner valve member is located within the hollow body and is spaced from the first valve member and defines a passage between the first and second valve members. The second valve member has a valve seat located within the body and a valve member which is pivotally mounted within the body which is biased by the spring into a closed position. The inner valve member or second valve member is located so that the catheter tube may be inserted through the third opening after the lid is positioned in an opened position and a stop sleeve thereof may be pushed in through the passage to open the inner valve to permit the cathether tube to be pushed through the stop sleeve into the fitting.
To facilitate the removal of the inner lid made entirely of plastic, it may be adviseable to provide the lid with an about H-shaped punched recess on the side facing outwardly when the lid is in closed position. Then, with the aid of a metallic bolt provided with a corresponding H-shaped elevation, and with the lid properly held fast from the opposite side, the journals can be pushed out of their bearing recesses. After cleaning, for example, the lid can be inserted again by simply pushing the journals into their bearing recesses.
It is advisable to make the outer lid arrestable in both the closed and open positions thereof, for example by snapping into retaining elements of corresponding shape.
In an advantageous development, the tubular catheter part may be provided on its proximal end with a connecting part for the suction line. This part is also enclosed in a tear-open casing of plastic which may in addition be filled with a disenfecting, protective gas.
Due to this provision of different casings of plastic, to be torn open separately, the catheter can be handled in a sterile manner, as explained hereinafter. Instead of plastic, the casings might also be made of another material of equivalent properties, such as thin metallic foil.
The claimed features make sure that the inventive adapter can be well handled, that it will be reliable in operation even under unclean conditions, and will be easy to clean and disinfect. A draining set comprising this suction adapter permits a virtually completely sterile introduction and withdrawal of the catheter.
Accordingly, it is an object of the invention to provide an improved suction adapter for connecting a suction catheter to a tracheal tube which is also connectable to a respirator. A further object of the invention is to provide a medical draining set which includes a catheter tube and a stop sleeve which are arranged within a closed plastic covering and in a manner such that the tube may be pushed through the stop sleeve after the sleeve is inserted into the fitting which has an outer valve and an inner valve which may be pressed opened after insertion of the stop sleeve.
A further object of the invention is to provide a method of draining a tracheal tube connection which comprises maintaining a catheter tube in a plastic covering, fitting a stop sleeve to a fitting for the tube and inserting the tube through the stop sleeve as it is moved out of the plastic covering, connecting the opposite end of the tube to a suction source, and after applying suction and draining the tracheal tube to withdraw the tube through the stop sleeve into the plastic covering.
A further object of the invention is to provide a suction adapter which is simple in design, rugged in construction and economical to manufacture.
The various features of novelty which characterize the invention are pointed out with particularity in the claims annexed to and forming a part of this disclosure. For a better understanding of the invention, its operating advantages and specific objects attained by its uses, reference is made to the accompanying drawings and descriptive matter in which preferred embodiments of the invention are illustrated.